ADVANCED FOOT AND ANKLE SPECIALISTS, PA
Jay S. Weingarten, DPM, FACFAS, FACFAOM
Podiatric Physician and Surgeon
Board Certified Physician – Treating Pediatrics to Geriatrics
Skin Graft
What Is a Skin Graft?
A skin graft is a surgical procedure that involves removing
skin from one part of your body (the donor site) and moving
it, or transplanting it, to a different part. This surgery may be
done if part of your body has lost its protective covering of
skin due to injury or illness.
Skin grafts are performed in a hospital. Most skin grafts are
performed using general anesthesia, which means that you
will sleep painlessly throughout the procedure.
Reasons for Skin Grafts
A skin graft is placed over an area of the body where the
skin has been lost. Some common reasons for skin grafts
include:
skin infections
deep burns
large, open wounds
bed sores or other ulcers on the skin that don’t heal well
Types of Skin Grafts
There are two basic types of skin grafts: split-level thickness
and full thickness.
Split-Level Thickness Grafts
A split-level thickness graft involves removing only the top
two levels of the skin—the epidermis and the dermis—from
the donor site. These grafts are used to cover large areas.
Split-level grafts tend to be fragile and have a shiny or
smooth appearance. They may also appear paler than the
adjoining skin.
Full-Thickness Grafts
A full thickness graft involves removing the muscles and
blood vessels as well as the top layers of skin from the
donor site. Full-thickness grafts are generally used for small
wounds on a highly visible part of the body, such as the
face. Unlike split-level thickness grafts, they blend in well
with the skin around them and usually grow with the
individual.
Skin Graft Preparation
You may need to stop taking certain medications, such as
aspirin, that interfere with the blood’s ability to form clots.
You should minimize stair climbing immediately after the
surgery and plan to have someone to stay with you to help
take care of you during your first few days at home.
Your doctor will tell you not to eat or drink anything after
midnight on the day of the surgery.
Skin Graft Procedure
You will arrive at the hospital on the morning of the surgery.
A nurse or a technician will help you get ready for the
operation by giving you a hospital gown to wear in place of
street clothes and starting an IV in your hand, arm, or wrist.
The IV allows your doctors to give you medicine and fluids
during and after the surgery.
When it is time for your operation, you will be taken into the
operating room. Once you are in the operating room, a
doctor will inject a medicine into your IV line. The medicine,
called general anesthetic, will make you fall asleep and stay
asleep throughout the surgery so that you don’t feel any
pain.
The surgeon will begin the operation by removing skin from
the donor site. If you are getting a split-level thickness graft,
the skin will be removed from an area of your body that is
usually hidden by clothes, such as your hip or the inside of
your thigh. If you are getting a full-thickness graft, the
preferred donor sites are the abdominal wall or the chest
wall.
Once the skin is removed from the donor site, the surgeon
carefully places it over the transplant area and fixes it in
place with a surgical dressing, staples, or stitches. He or she
will also cover the donor area with a dressing that won’t stick
to the wound.
Aftercare for a Skin Graft
You will wake up in the recovery room. The staff will watch
you closely after surgery, monitoring your vital signs and
giving you medications to manage pain. When the staff is
sure you are stable, you will be taken to a hospital room to
continue your recovery.
The graft should start developing blood vessels to connect it
with the skin around it within 36 hours. If these blood
vessels do not begin to form, it could be a sign that your
body is rejecting the graft. You may hear doctors say that
the graft “hasn’t taken.” If the graft doesn’t take, you may
require another operation and a new graft.
Your doctor will probably discharge you with a prescription
for painkillers and instructions about how to care for the graft
site and the donor site to avoid infection.
Avoid activities that stretch or pull the graft site for at least
three to four weeks. The donor site will heal within two to
three weeks. Your doctor will tell you when it is safe to
resume your normal activities.
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